Steroid treats oral lichen planus

Dear Dr. Roach: Is there anything I can do to relieve the pain and suffering from oral lichen planus?

Answer: Nobody knows what causes lichen planus, an uncommon (less than 1% of people) skin condition that may also affect the mouth or vagina. It most often occurs during the ages of 30 to 60. It is more common in people with a history of hepatitis C.

Medical students are taught the four “P’s” of lichen planus: pruritis (itchy, often intensely itchy), purple, polygonal, plaques (raised lesions). The plaques often have fine white lines, especially in the condition you are asking about, oral lichen planus.

Oral lichen planus often causes pain, especially when eating.

The most effective treatment for oral lichen planus is a potent topical corticosteroid, such as clobetasol, usually placed on the affected areas with a cotton swab.

There are some techniques for keeping the medicine on the affected areas that your dermatologist can tell you about.

People who do not respond to topical steroids (it can take a couple of months to get maximum effect) are usually treated with a more powerful medicine, such as tacrolimus.

In my experience, lichen planus is usually relieved by treatment — though, perhaps not 100%.

In most people, lichen planus mysteriously disappears within a few years of it coming on.

Dear Dr. Roach: Iam a 76-year-old female. In your opinion, should I continue to have annual exams by my gynecologist?

Answer: The evidence is strong that Pap smears are of little value in (most) women over 65, but I still believe a woman should continue to see a gynecologist (or whomever she has been seeing for routine gynecologic care).

There are many concerns a woman has as she gets older, and common conditions benefit from a relationship with a provider expert in women’s care.